Search

The differential diagnosis of eosinophilia may sometimes be difficult. Eosinophilia may occur in a diverse array of conditions from parasitic infestations to malignacies. Idiopathic hypereosinophilic syndrome has also been described. A 65-year-old male patient presenting with eosinophilia of obscure etiology is described in the present report. Three years after the diagnosis of eosinophilia, metastatic anaplastic carcinoma of unknown primary was detected. Differential diagnosis is disscussed briefly. It is stressed that patients with hypereosinophilia of unknown etiology must be screened for malignancy regularly during follow up. [ABSTRACT FROM AUTHOR]

Radioembolization is used in diagnostic imaging of the lungs and for radioembolization therapy of hepatic tumours. Presently, 99mTc labelled macroaggregates or microspheres of human serum albumin (HAM) are used for this purpose. Poly lactic acid (PLA) is biodegradable, like HAM, and, unlike HAM, is not a blood product. The aim of the present study was to evaluate the uptake and biodegradation of PLA microspheres in lungs. PLA (MW=48720Da) microspheres of 1.0-100mum (mean=39.5mum) in diameter were prepared by solvent evaporation frommethylene chloride. They were labelled with 99mTcby stannous chloride reduction at pH3, with an efficiency of 98%and a stability of 96%at 24h. For biodistribution studies, 15 mice were i.v. injected with 20muCi 99mTc-PLA microspheres in 0.1ml and sacrified at 15min, 1, 3, 6 and 24h (three at each time point). All the organs were removed, weighed and counted against a standard prepared from 1/100 dilution of the injected radioactivity. Some mice were similarly injected and sacrified at 30min, 15 and 30 days. The lungs were removed and frozen, and 10mum sections were obtained, stained with haemotoxylin and eosin and examined under a light microscope. Five rabbits were i.v. injected with 1mCi of 99mTc-PLA microspheres. Scintigrams were obtained at various intervals up to 24h. In mice, the lung uptake was significant at 30min-1h post-injection. In rabbits, the lungs were the only organs visualized up to 24h. Microscopic examination of tissue sections demonstrated slow biodegradation of PLA particles. In conclusion; (1) The high lung uptake obtained in mice and rabbits indicates the suitability of PLA microspheres for lung imaging, and (2) although the slow biodegradation rate might be a disadvantage in patients with lung disorders in diagnostic studies, it may be an advantage in therapeutic applications with radionuclides which have long physical half lives. [ABSTRACT FROM AUTHOR]

- The correlation between tissue localisation and serum levels of alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) was studied in 20 tissue samples from 18 patients with non-seminomatous testicular tumours. Specific immunoperoxidase stains were used for tissue staining and serum measurements were made by radioimmunoassay. There was a close correlation between the tissue demonstration of AFP and HCG and elevated levels of serum markers. The cellular localisations of AFP and HCG were different and no cell stained concomitantly for both AFP and HCG. From these results and from the demonstration of tumour markers in the tissue of some patients with normal serum marker levels, it was concluded that immunocytochemical localisation of the tumour markers was more sensitive than serum measurements. [ABSTRACT FROM AUTHOR]

Copyright of International Orthopaedics is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Liposarcomas of the head and neck region are rare. Those originating in the buccal mucosa cause special diagnostic and therapeutic difficulties. In this report, a predominantly well-differentiated liposarcoma of the cheek in a 32-yr- old man is reported. The tumor continued to grow slowly over a period of 3 yr before definitive diagnosis was established. Radical maxillectomy was performed with total excision of the tumor. Recommendations for earlier and correct diagnosis and treatment of this rare neoplasm are discussed. [ABSTRACT FROM AUTHOR]

Objectives: A continuous-flow centrifugal blood pump system has been recently developed as an implantable left ventricular assist device for patients with endstage heart failure. The objective of this study was to evaluate the initial in vivo performance of a newly developed left ventricular assist device (iHeart or Istanbul heart; Manufacturing and Automation Research Center, Koc University, Istanbul, Turkey) in an acute setting using a pig model., Materials and Methods: Three pigs (77, 83, 92 kg) received implants via a median sternotomy, with animals supported for up to 6 hours. An outflow cannula was anastomosed to the ascending aorta. Anticoagulation was applied by intravenous heparin administration. During the support period, pump performance was evaluated under several flow and operating conditions. All pigs were humanely sacrificied after the experiments, and organs were examined macroscopically and histopathologically., Results: Flow rate ranged between 1.5 and 3.6 L/min with pump speeds of 1500 to 2800 revolutions/min and motor current of 0.6 to 1.3 A. Initial findings confirmed thatthe iHeart ventricular assist device had sufficient hydraulic performance to support the circulation. During the experimental period, plasma free hemoglobin levels were found to be within normalranges.Thrombus formation was not observed inside the pump in all experiments., Conclusions: The iHeart ventricular assist device demonstrated encouraging hemodynamic performance and good biocompatibility in the pig model for use as an implantable left ventricular assist device. Further acute in vivo studies will evaluate the short-term pump performance prior to chronic studies for long-term evaluation.

The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Purpose: To describe a case of an epitheloid hemangioendothelioma which is a tumor of endothelial origin with borderline malignancy between hemangioma and angiosarcoma and which is very rare in the orbit., Methods: Clinical features, results of imaging and histopathological studies and postoperative clinical course of a 22-year-old female patient who presented with a gradual swelling of the left upper eyelid were reviewed., Results: Magnetic resonance imaging studies suggested a solid lesion with moderate contrast enhancement in the palpebral lobe of the lacrimal gland. A short course of systemic corticosteroid therapy failed to resolve the lesion. Excisional biopsy of the tumor yielded the diagnosis of epitheloid hemangioendothelioma of the lacrimal gland. The tumor was composed of nests of epitheloid cells, some forming CD31 positive intracytoplasmic vascular channels containing erythrocytes. CD34 and EMA were also positive and desmin, SMA, p63, S100, Factor VIII and HHV-8 were negative on immunohistochemical studies. During 44 months of follow-up, there has been no recurrence or systemic metastasis., Conclusion: Epitheloid hemangioendothelioma can occur in the palpebral lobe of the lacrimal gland as a hard, painless, immobile mass. Simple excisional biopsy of the tumor, assumed to have an intermediate malignancy grade, without further local or systemic therapy provided a disease-free 3-year survival.